Influenza-induced rhabdomyolysis

Martin Runnstrom; Alex M Ebied; Adonice Paul Khoury; Raju Reddy

doi:10.1136/bcr-2018-226610

Influenza-induced rhabdomyolysis

BMJ Case Rep. 2018 Dec 4;11(1):e226610. doi: 10.1136/bcr-2018-226610.

Authors

Martin Runnstrom¹, Alex M Ebied², Adonice Paul Khoury², Raju Reddy³

Affiliations

¹ Department of Medicine, University of Florida, Gainesville, Florida, USA.
² Department of Pharmacotherapy and Translational Research, College of Pharmacy, University of Florida, Gainesville, Florida, USA.
³ Department of Pulmonary Disease and Critical Care Medicine, University of Florida, Gainesville, Florida, USA.

Abstract

Rhabdomyolysis is characterised by muscle breakdown with release of damaging proteins that can have devastating consequences. Acute influenza infection is being increasingly recognised as an underlying aetiology. We report an unusual case of severe rhabdomyolysis with acute renal failure due to influenza A infection that improved with high-dose oseltamivir and intravenous fluids. In our case, we also noticed a temporal relation between fever spikes and subsequent increase in serum creatine kinase. The precise mechanism between the rise in temperature and creatine kinase is unclear but it could be due to direct viral invasion of myocytes or due to release of new viral progeny following replication in the myocyte.

Keywords: acute renal failure; adult intensive care; drugs: infectious diseases; influenza.

Publication types

Case Reports

MeSH terms

Adult
Cerebral Palsy
Creatine Kinase / blood
Diagnosis, Differential
Humans
Influenza, Human / complications
Influenza, Human / diagnosis*
Male
Rhabdomyolysis / blood
Rhabdomyolysis / complications
Rhabdomyolysis / diagnosis*
Seizures

Substances

Creatine Kinase